shades of grey…
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probe prevents probe…
Recently, a colleague of mine was wanting to perform a diagnostic tap on a patient with cough, fever and a CXR suggesting a left sided pleural effusion…. I was asked to perform a bedside USS to mark out the safest…
a troublesome tachycardia
The Case. An 11 year old boy is bought to ED by his mother on a busy weekday evening. Mum reports that he has been ‘a little bit off’ over the past 24 hours, in particular he’s not keeping down…
big black spider…
The Case. A sunny Saturday morning in Sydney and your 56 year old patient was just outside doing some gardening when they feel a rather sharp bite on their right hand (on webspace between thumb and index finger). He arrives…
R&R In The FASTLANE 028
Research and Reviews (R&R) in the FastLane: experts worldwide tell us what they think is worth reading from emergency medicine and critical care literature
a difficult airway…
The Case. The ‘Batphone’ alerted us of a 68 year old female who is postictal following two seizures in rapid succession. She has a history of ‘a brain tumour’. P 120. BP 176 systolic !! GCS 8 Afebrile. Sats 98%…
another ECG case…
The Case. I was superficially involved in this case of a 32 year old suicidal patient who ingested two full packets of Solian (amisulpride) (~ 24 grams) approximately 90 minutes prior to arrival to ED. On initial assessment he was…
slowly, slowly…
Case: 76 year old female, presents with lightheadedness and lethargy. She is complaining of mid-scapular pain & is syncopal at triage. She has cold hands & clammy skin. Systolic BP 70 mmHg. Crackles to mid-zones of her chest. Distended JVP.…
generally unwell (part 2)…
For those joining the story for the first time, you can catch up here…. My interpretation of the ECG; Sinus rhythm with 1st degree HB, an ‘odd’ axis. Wide complex QRS (~140-160ms) with symmetrical tall T-waves. ? Hyperkalaemia. Needs urgent…
generally unwell…
The setting: Busy Saturday morning shift. Lots on the go as usual… You sit for a moment to catch up on your notes and review patient results… A nurse hands you this ECG to sign-off saying, “this lady is generally…
more than man-flu…
The case: 19 year old male who presented as ‘lethargic & generally unwell’ is wheeled into resus. He is so weak it takes 2 staff and his father to lift him from the wheelchair to our stretcher. He looks horrible.…
observing the occult…
The case: A motorcyclist is minding his own business, stationary at a set of lights and is rear-ended by a car at ~60-70km He is thrown 10 meters or so from his bike and lands on his left side. Remarkably…